POS0656 DOES RADIOGRAPHIC STATUS IMPACT SECUKINUMAB EFFECTIVENESS IN EUROPEAN AXIAL SPONDYLOARTHRITIS PATIENTS TREATED IN ROUTINE CARE?
Authors: S. N. Christiansen, S. H. Rasmussen, M. Østergaard, B. Michelsen, K. Pavelka, C. Codreanu, A. Ciurea, B. Glintborg, M. J. Santos, İ. Sari, Z. Rotar, B. Gudbjornsson, J. Zavada, C. Mogosan, M. J. Nissen, A. G. Loft, A. Barcelos, Y. Erez, K. Pirkmajer, G. Gröndal, M. L. Hetland, L. Midtbøll Ørnbjerg
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The impact of radiographic status on real-world secukinumab treatment effectiveness in axial spondyloarthritis (axSpA) patients is unknown. <h3>Objectives</h3> To compare the treatment effectiveness of secukinumab in radiographic (r-) <i>vs.</i> non-radiographic (nr-) axSpA patients treated in routine care across Europe. <h3>Methods</h3> Prospectively collected data on secukinumab-treated axSpA patients with known radiographic status followed in routine care in the EuroSpA collaboration <sup>[1]</sup> were pooled from 9 countries. Patients were listed as r-axSpA if registered to fulfil the modified New York <sup>[2]</sup> or the radiographic ASAS classification <sup>[3]</sup> criteria. If patients were registered to fulfil neither criterion or if they did not fulfil one criterion and the other was unknown, patients were registered as nr-axSpA. Patient-reported outcome (PRO) remission rates including pain (VAS≤20), Bath Ankylosing Spondylitis Disease Activity (BASDAI≤20) and Functional Index (BASFI≤ 20) (all in the form of 0–100 visual analogue scale), and Ankylosing Spondylitis Disease Activity Score-CRP (ASDAS inactive disease &lt;1.3) after 6, 12 and 24 months of secukinumab treatment were calculated. Remission rates in r-axSpA <i>vs.</i> nr-axSpA patients were compared by logistic regression analyses in an unadjusted model (MODEL1), a model adjusted for age/gender (MODEL2) and a model adjusted for age/gender/country/previous bDMARD (yes/no)/baseline CRP/years since diagnosis to secukinumab initiation (MODEL3). For MODEL3, parameter estimates (CRP) from 100 imputed data sets were pooled using Multivariate Imputation by Chained Equations. <h3>Results</h3> Patients with r-axSpA had longer disease duration at secukinumab initiation, were more frequently males and HLA-B27 positive compared to nr-axSpA patients. PROs at baseline were largely similar between groups, while CRP and ASDAS-CRP were higher in r-axSpA patients. A higher percentage of nr-axSpA patients had received previous bDMARDs compared to r-axSpA patients. Crude PRO remission rates at 6/12/24-months were significantly lower in nr-axSpA compared to r-axSpA patients (Table 1, Figure 1 (MODEL1)) as were percentages of patients in ASDAS inactive disease (Table 1). However, when adjusting for age/gender (MODEL2) the difference in PROs diminished, and when adjusting for multiple possible confounders (MODEL3), no significant differences were found between the two groups (Figure 1). Differences in percentages of patients in ASDAS inactive disease in r-axSpA <i>vs.</i> nr-axSpA patients were almost unaffected by adjustments (Figure 1). <h3>Conclusion</h3> While crude remission rates in European secukinumab-treated patients followed in routine care were higher in r-axSpA compared to nr-axSpA patients, this difference disappeared after adjusting for multiple confounders, and, thus, appeared to be related to other factors than radiographic status. <h3>References</h3> [1]https://eurospa.eu/ [2]van der Linden et al. Arthritis Rheum 1984. [3]Rudwaleit et al. Ann Rheum Dis 2009. <h3>Acknowledgements</h3> Novartis Pharma AG for supporting the EuroSpA collaboration. <h3>Disclosure of Interests</h3> Sara Nysom Christiansen Speakers bureau: BMS, Novartid and GE, Grant/research support from: Novartis, Simon Horskjær Rasmussen: None declared, Mikkel Østergaard Speakers bureau: Abbvie, BMS, Boehringer-Ingelheim, Celgene, Eli-Lilly, Hospira, Janssen, Merck, Novartis, Novo, Orion, Pfizer, Regeneron, Roche, Sandoz, Sanofi, UCB, Consultant of: Abbvie, BMS, Boehringer-Ingelheim, Celgene, Eli-Lilly, Hospira, Janssen, Merck, Novartis, Novo, Orion, Pfizer, Regeneron, Roche, Sandoz, Sanofi, UCB, Brigitte Michelsen Grant/research support from: Novartis, Karel Pavelka Speakers bureau: Pfizer, MSD, BMS, UCB, Amgen, Egis, Roche, AbbVie, Consultant of: Pfizer, MSD, BMS, UCB, Amgen, Egis, Roche, AbbVie, Catalin Codreanu Speakers bureau: AbbVie, Amgen, Boehringer Ingelheim, Ewopharma, Lilly, Novartis, Pfizer, Consultant of: AbbVie, Amgen, Boehringer Ingelheim, Ewopharma, Lilly, Novartis, Pfizer, Adrian Ciurea Speakers bureau: AbbVie, Novartis, Bente Glintborg Grant/research support from: Pfizer, Abbvie, BMS, Maria Jose Santos Speakers bureau: Abbvie, AstraZeneca, Lilly, Novartis, Pfizer, İsmail Sari: None declared, Ziga Rotar Speakers bureau: Abbvie, Novartis, MSD, Medis, Biogen, Eli Lilly, Pfizer, Sanofi, Lek, Janssen, Consultant of: Abbvie, Novartis, MSD, Medis, Biogen, Eli Lilly, Pfizer, Sanofi, Lek, Janssen, Björn Gudbjornsson Speakers bureau: Novartis and Nordic Pharma, Consultant of: Novartis and Nordic Pharma, Jakub Zavada Speakers bureau: Abbvie, Elli-Lilly, Sandoz, Novartis, Egis, UCB., Consultant of: Abbvie, Elli-Lilly, Sandoz, Novartis, Egis, UCB., Corina Mogosan: None declared, Michael J. Nissen Speakers bureau: AbbVie, Eli Lilly, Janssens, Novartis, Pfizer, Consultant of: AbbVie, Eli Lilly, Janssens, Novartis, Pfizer, Anne Gitte Loft Speakers bureau: AbbVie, Janssen, Lilly, MSD, Novartis, Pfizer, Roche, UCB, Consultant of: AbbVie, Janssen, Lilly, MSD, Novartis, Pfizer, Roche, UCB, Anabela Barcelos Speakers bureau: Abbvie, Janssen, Novartis, Consultant of: Abbvie, Lilly and Novartis, Yesim Erez: None declared, Katja Pirkmajer Speakers bureau: Abbvie, Novartis, MSD, Medis, Eli Lilly, Pfizer, Lek, Janssen, Consultant of: Abbvie, Novartis, Medis, Eli Lilly, Pfize, Boehringer Ingelheim, Gerdur Gröndal: None declared, Merete Lund Hetland Speakers bureau: Pfizer, Medac, Sandoz, Grant/research support from: Abbvie, Biogen, BMS, Celltrion, Eli Lilly, Janssen Biologics B.V, Lundbeck Fonden, MSD, Medac, Lykke Midtbøll Ørnbjerg Grant/research support from: Novartis.